Addiction Medicine Made Easy | Fighting back against addiction

Casey Grover, MD, FACEP, FASAM
  • 5.0 (3)
  • Medicine
  • Updated Weekly

Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us. *This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*

  1. 3d ago

    A Practical Guide To Psychiatric Medications For Addiction Care (Update from 2025)

    Psychiatric meds can feel like a maze when someone is trying to get sober and also sleep, focus, and stop panic spirals all in the same week. We made this updated, practical overview to simplify psychopharmacology for addiction treatment and recovery, using plain language and real clinical decision-making instead of jargon or hype. We start by clearing up a viral rumor and then zoom out to how medications are actually created: research pathways, FDA indications, “me-too” drugs, and why off-label prescribing is so common in psychiatry. From there, we walk through the major medication classes and what they are truly used for, including antidepressants (SSRIs, SNRIs, mirtazapine, bupropion), anxiety and insomnia options that are less risky in recovery, and the basics of antipsychotics and mood stabilisers for severe symptoms like psychosis and bipolar disorder. We also touch on pharmacogenomics testing such as GeneSight and why individual response can still require careful trial and adjustment. Because addiction medicine demands extra caution, we spend real time on benzodiazepine risks, why Z-drugs like Ambien can be problematic, and what we reach for instead when someone needs immediate anxiety relief while antidepressants take weeks to work. We wrap with a clinical case that shows how we prioritise conditions, pick meds that can treat more than one target, and avoid starting too many at once. If this helps you, subscribe, share it with a colleague, and leave a rating or review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com

    36 min

  2. Jun 15

    What's The Latest With Kratom?

    Kratom is being sold like a simple plant, but the way it’s packaged, concentrated, and marketed in 2026 can turn it into something much closer to an opioid problem hiding in plain sight. We’re taking you through a practical, clinician-friendly update drawn from a talk I gave to local therapists and drug and alcohol counselors, especially as the political and regulatory landscape shifts and bans and enforcement efforts expand in places like California. We break down what kratom is (Mitragyna speciosa), why it can feel stimulating at low doses, and why higher doses bring opioid-receptor effects that can lead to tolerance, dependence, and withdrawal. We also cover what kratom overdose can look like, why mixing kratom with fentanyl, alcohol, or THC raises risk, and why naloxone still belongs in the conversation even when the data is often limited to case reports. Then we get real about how people actually encounter kratom today: smoke shop “strain” menus, euphoric promises, and an online retail experience that’s faster and easier than getting medical care. The most important update is potency. Extracts are changing the game, and 7-hydroxymitragynine (7-OH) may be sold under the kratom label while acting like a far more powerful opioid. Finally, we lay out treatment pathways we use in addiction medicine, including comfort meds, tapering, Suboxone or methadone, and long-acting injectable buprenorphine (Sublocade/Brixadi) that can help some people step down without a brutal withdrawal. If this helped you understand kratom, share it with a colleague or a friend, subscribe for more practical addiction medicine, and leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com To see the podcast's ranking on millionpodcasts.com:  https://www.millionpodcasts.com/addiction-medicine-podcasts/

    34 min

  3. Jun 8

    I Don't Have a Drinking Problem. I Drink, I Get Drunk. No Problem.

    Binge drinking can look harmless right up until it doesn’t. If you only drink on weekends, vacations, or big nights out, it’s easy to tell yourself you’re fine because you’re not drinking every day. But the consequences of one high-risk night can be life-changing, and clinically, intermittent heavy drinking can still meet criteria for an alcohol use disorder. I’m joined by Colleen Clifford, a former binge drinker who spent 36 years working at sea as a commercial fisherwoman and is now transitioning into health coaching to help clients manage binge drinking and binge eating. Colleen shares the personal grief that shaped her mission, the stories she used to justify “normal” partying, and the turning-point moment that made her drop alcohol for good. We also get practical about what actually counts as a binge, including how “one drink” is often smaller than the glass in your hand. We discuss the DSM-5 criteria for alcohol use disorder, how many people who binge drink do not think they have a problem, and why cravings can still show up years later. Colleen explains how she handles urges by observing them, naming the discomfort, and playing the tape forward. I also share a harm-reduction option many people don’t know about: medications like naltrexone that, for some patients, can be taken before drinking to reduce binge episodes. We wrap with trends like alcohol-free wine and shifting drinking culture across generations, plus Colleen’s core message: it only takes one moment of drinking too much to change your life forever. Subscribe, share this with someone who’s questioning their relationship with alcohol, and please leave a review so more people can find the show. To learn more about Colleen and her work: https://purepotential.health/ To contact Dr. Grover: ammadeeasy@fastmail.com

    37 min

  4. Jun 1

    Sugar: When The Kitchen Cabinet Is Your Drug Dealer

    Sugar is everywhere, socially approved, and often handed out as comfort, reward, and love. That’s exactly why it can be so hard to spot when it stops being “a treat” and starts acting like an addiction. I’m Dr. Casey Grover, and I sit down with Mike Collins, known as the Sugar Free Man, for a clear-eyed talk about what sugar addiction looks like in real people’s lives and why willpower is such an unreliable tool when cravings take over. We get into the recovery lens: triggers, cravings, relapse language, and the emotional roots of using sugar to self-soothe. Mike shares how his own family history shaped his relationship with sweets, how his coaching and meeting-based community grew during COVID, and why support groups can be the difference between “trying again” and actually changing behavior. We also talk about who shows up for help, why so many people seek weight loss or type 2 diabetes relief first, and how diet culture has often missed the point. Then we go deeper on the science Mike leans on, especially fructose. We discuss why fructose may be a key driver of cravings, how it’s processed in the liver, and why gut health topics like "leaky gut" get brought up in the sugar conversation. Finally, we compare moderation vs abstinence, how eating disorder treatment can clash with sugar-free protocols, and how finding healthier dopamine through exercise can support long-term recovery. If this conversation helps you see your own pattern more clearly, subscribe, share it with someone who’s stuck in the loop, and leave a review so more people can find the show. To learn more about Mike's work: https://sugaraddiction.com https://www.skool.com/no-sugar-nation/about To contact Dr. Grover: ammadeeasy@fastmail.com

    47 min

  5. May 25

    I Get By (And Sober) With A Little Help From My Peers

    Peer support can feel like the missing link in addiction care, not because it replaces medicine, but because it makes recovery feel possible when someone is scared, ashamed, or shutting down. I’m Dr Casey Grover, and I sit down with Mark Ehrenkranz, a certified peer recovery specialist who does bedside work across a thousand-bed hospital, from the ED and ICU to behavioral health. Mark brings decades of recovery experience, plus the clarity that comes from having lived through relapse, depression, and the brutal way substance use disorder can hijack decision-making. We get practical about what peer recovery specialists actually do: building trust quickly, sharing just enough personal story to invite radical honesty, translating brain science into plain language, and helping patients move from crisis to a realistic next step. We also talk about the real-world barriers, including stigma in medical settings, limited funding for peer teams, and how different states handle certification and reimbursement. If you’ve ever searched for recovery coaching, peer recovery support services, sober support, or how to get help for addiction, this conversation maps the terrain with honesty and hope. We also go straight at the “one path” problem. AA helps many people, but it can feel dogmatic to others, so we discuss multiple pathways like SMART Recovery, CBT/DBT, secular and Buddhist recovery, online communities, and medication for opioid use disorder support spaces. Mark shares his “Navy SEAL Recovery” approach to nervous system regulation: one-minute diaphragmatic breathing, humming to stimulate the vagus nerve, and small doses of intentional discomfort to build resilience. If you care about compassionate, evidence-informed addiction treatment that respects individual fit, you’ll leave with tools you can use today. Subscribe, share this with someone who needs it, and leave a review so more people can find the show. To learn more about Mark's work: https://www.go-humans.com/ To contact Dr. Grover: ammadeeasy@fastmail.com

    47 min

  6. May 18

    A New Way to Think About Addiction: The Stress Reducer Loop

    Your go-to stress relief can become the biggest source of stress in your life, and that’s where recovery often gets stuck. I’m joined by Dr Gary Sprouse, the “Less Stress Doc,” to unpack his deceptively simple framework called the Stress Reducer Loop: a substance or behavior lowers stress at first, then starts causing harm, which creates more stress, which drives more use. Once you see the loop clearly, it’s easier to replace shame with strategy. We also dig into why the way we talk about addiction matters. Dr Sprouse explains how the disease label can backfire for some people by making them feel broken, abnormal, and permanently marked, so they wait until rock bottom to get help. His alternative framing treats alcohol, opioids, smoking, shopping, even over-exercising as attempts at “treatment” for stress. That perspective keeps the conversation practical: how do we reduce stress, and how do we swap in a lower-harm stress reducer? From Suboxone as a safer replacement for fentanyl or heroin, to relapse mechanics like brain “tracks,” inhibition, deprivation, and dwindling “quit energy,” we translate addiction medicine into plain language you can use. We also cover concrete stress tools like setting boundaries, changing expectations, and “de-lumping” overwhelming problems, plus why past trauma can silently consume most of a person’s stress capacity. If this helped you see addiction, relapse prevention, and stress management in a new way, subscribe, share the episode with someone who needs it, and leave a review so more people can find the show. To learn more about Dr. Sprouse's work: https://www.thelessstressdoc.com/ To contact Dr. Grover: ammadeeasy@fastmail.com

    52 min

  7. May 11

    Whipped Cream With A Side Of Spinal Cord Damage

    Nitrous oxide can look like a harmless party trick until you understand how fast it can flip into a medical emergency. We dig into whippets and laughing gas from an addiction medicine perspective, including why the high hits within seconds, why people keep reaching for “just one more,” and how the same drug can functionally mimic ketamine, benzodiazepines, and opioids in the brain. That mix helps explain both its legitimate role in minor procedures and why it can be so addictive outside the clinic.  We walk through what clinicians and families often miss: standard urine drug screens do not detect nitrous oxide, the detection window is short even with advanced lab testing, and the clearest red flag may be a profound vitamin B12 deficiency in someone who should not have it. From there, the conversation turns to the real stakes of B12 inactivation: spinal cord degeneration, myelopathy, peripheral neuropathy, gait instability, weakness, bladder dysfunction, cognitive changes, and the uncomfortable truth that we often cannot predict whether nerve damage will be permanent. We also cover immediate dangers while using, including hypoxia and sudden unconsciousness, traumatic falls, frostbite and cold burns from direct canister inhalation, pneumothorax and pneumomediastinum, arrhythmias especially when mixed with stimulants, mental health destabilization, increased blood clot risk, and serious pregnancy risks.  Because there is no proven medication-assisted treatment for nitrous cravings, we focus on what we can do: treat co-occurring anxiety, depression, and trauma, use CBT and group therapy, push hard on vitamin B12 replacement, and apply practical harm reduction when someone is not ready to quit. We close with a vivid patient case that shows how smoke shop access and relapse can spiral into hospitalization and disability, and how recovery is still possible with the right support.  If you find this helpful, subscribe, share the episode with someone who needs it, and leave a review so more people can find the show. To contact Dr. Grover: ammadeeasy@fastmail.com

    34 min

  8. May 4

    Goodbye Benzos, My Old Friend: Benzodiazepine Tapering Done Right

    A benzodiazepine taper can feel like trying to land a plane in bad weather: the stakes are high, the instruments are imperfect, and speed is rarely your friend. We sit down with Dr. Rizzo to translate the ASAM benzodiazepine tapering guideline into real-world addiction medicine decisions, including what to do when a patient shows up on a very high dose of clonazepam and a sudden 50% cut has already happened. We dig into the practical details clinicians and patients search for: how fast to reduce dose, why “5% to 10% every 2–4 weeks” is often a safer starting point, and when switching to a longer-acting benzodiazepine like diazepam helps or hurts. We also separate physical dependence from benzodiazepine use disorder so withdrawal is treated with seriousness rather than stigma, and we talk candidly about the access-to-care problem when long-term benzo patients can no longer find a prescriber. We also cover special risks and settings: why older adults (65+) often need extra-slow tapers, why pregnancy requires careful coordination to avoid abrupt cessation, and when polysubstance use with opioids or alcohol should push care toward inpatient or residential support. Dr. Rizzo shares why phenobarbital can be useful in controlled detox settings, plus what actually improves success long term: CBT, treating underlying anxiety and insomnia with non-addictive medications, and building a plan patients can stick with. If this helps, subscribe, share it with a colleague or family member, and leave a review so more people can find evidence-based guidance on benzodiazepine tapering and withdrawal. ASAM Benzo Tapering Guideline: https://link.springer.com/article/10.1007/s11606-025-09499-2 To contact Dr. Grover: ammadeeasy@fastmail.com

    51 min
See All (185)

Ratings & Reviews

5
out of 5
3 Ratings

About

Addiction is killing us. Over 100,000 Americans died of drug overdose in the last year, and over 100,000 Americans died from alcohol use in the last year. We need to include addiction medicine as a part of everyone's practice! We take topics in addiction medicine and break them down into digestible nuggets and clinical pearls that you can use at the bedside. We are trying to create an army of health care providers all over the world who want to fight back against addiction - and we hope you will join us. *This podcast was previously the Addiction in Emergency Medicine and Acute Care podcast*

Information

You Might Also Like